Making Nursing Homes Better - Mandate Minimum Staffing

​In the U.S., there are over 18,000 nursing homes and assisted living facilities caring for about a million residents. These facilities provide essential services for our aging population, but many of them fail to meet the needs of their residents. To make matters worse, the demand for these services is only expected to increase in the coming years. Therefore, it is critical that we take action now to ensure that the quality of care improves instead of continuing to decline. That’s why states like New Hampshire have taken proactive measures to mandate minimum staffing standards in nursing homes and assisted living facilities. This article explains why mandating minimum staffing in nursing homes and assisted living facilities is important, what minimum staffing standards look like across different states, best practices you can implement as an administrator or caregiver in a long-term care facility, and much more.

What is mandated minimum staffing?

Mandated minimum staffing refers to state laws that require nursing homes to maintain a certain number of staff members during each shift. The goal of these laws is to help improve the quality of care in nursing homes by increasing the number of licensed nurses and care providers. Depending on the state you live in, mandated minimum staffing requirements could mandate the number of registered nurses (RNs), licensed practical nurses (LPNs), or certified nursing assistants (CNAs) needed to care for a certain number of residents during certain times.

Why is mandating minimum staffing important?

Inadequate staffing has been linked to poor quality of care and higher rates of injury and death among both patients and workers in nursing homes. Therefore, mandating minimum staffing is important because it helps to ensure that facilities are able to meet the needs of their residents. Unfortunately, many nursing homes across the U.S. currently fall short of state staffing requirements. In fact, a study found that 80% of nursing homes do not meet minimum staffing requirements. It’s important to note that issues with staffing are not unique to nursing homes. As of 2017, there are no federal or state laws mandating minimum staffing requirements in assisted living facilities. That’s why legislation like New Hampshire’s Nursing Home Staffing Standard is so important. Mandated minimum staffing requirements help to ensure that both residents and workers are safe and cared for in an appropriate manner.

How does mandating minimum staffing work?

Nursing homes and assisted living facilities are required to provide an adequate level of care to their residents. However, there is no mandated definition for what constitutes “adequate.” This leaves facilities with a lot of leeway when it comes to defining the level of care that they’re able to offer. As a result, many of the existing staffing guidelines fall far below the minimum levels required for safe, quality care. For example, some facilities may only require 1.5 CNAs per eight residents during daytime hours. Meanwhile, the recommended number of CNAs per eight residents is three. That’s where state mandated minimum staffing requirements come in. Mandated minimum staffing laws require facilities to meet a certain level and number of staff members during each shift. This helps to ensure that residents receive adequate and consistent care.

Which states currently have a mandated minimum staffing requirement?

Currently, only New Hampshire has enacted state-mandated staffing requirements. This law requires a 1:3 nurse-to-resident ratio during daytime hours and 1:4 nurse-to-resident ratio at night. Additionally, other states like New York, Connecticut, and Michigan have proposed legislation to mandate minimum staffing.

Best practices for improving care with mandated minimum staffing

There are a few things you can do to ensure that you’re meeting and exceeding state mandated minimum staffing requirements in your facility. Here are a few best practices to implement: - Conduct a thorough and accurate assessment - Before you can implement any type of care, you must first assess the level and type of care that each resident requires. If a resident is incontinent, then you’ll need a change of clothes and a sanitizer nearby. If a resident has a feeding tube, then you’ll need to have the supplies and tools necessary to clean the tube and administer the feeding. Conducting a thorough and accurate assessment of each resident will help to ensure that you’re providing the level of care that each resident needs. - Have a detailed plan for each resident - Each resident in your facility has specific care needs and requirements. Some residents may need help with daily activities like bathing and eating, while other residents may need more extensive care like assistance with medications and medical equipment. Having a detailed plan for each resident will ensure that you’re meeting their needs and providing the level of care that they require. - Keep track of your staffing levels - Meeting state mandated minimum staffing levels is important, but it’s not enough. You also need to ensure that your facility is meeting the required levels on a consistent basis. You can do this by keeping track of your staffing levels and comparing them to your staffing plan.

Conclusion

Mandating minimum staffing requirements in nursing homes and assisted living facilities is important because it helps to improve the quality of care in long-term care facilities. Inadequate staffing has been linked to poor quality of care, so it’s critical that we implement laws that help to ensure that residents are receiving the care that they deserve. If your state has not yet enacted laws mandating minimum staffing requirements, now is the time to speak up and let your legislators know that you support mandated minimum staffing.